Salesperson Exam/License Application (435) - dre.ca.gov

1 This checklist may be used for either the Salesperson or broker Exam/License applications . Read appropriate license instructions carefully (RE 435A or RE 436A). Application must list your legal name. Items to be included in your packet are listed below. Check off each item as you assemble your packet. Mail completed Application package and fee to:Department of Real Box 137001 Sacramento, CA 95813-7001 Broker ApplicAntsRequired documents .. RE 436 Completed and signed by applicant. Documentation to establish examination course requirements have been met. Refer to RE 423 for current requirements. Official transcripts. Course completion certificates. Documentation showing experience requirements have been met. Please note that depending on your circumstances, one or more of the forms listed below may be required. RE 226 Documenting licensed experience. RE 227 Documenting equivalent experience. RE 228 Two RE 228's are required if unable to obtain broker's signature on RE 226 form.

2 RE 237 (See below.) Completed by applicant and live scan service operator. license fee Refer to RE 206 for current fees. Cashiers check, check, or money order made payable to: Department of Real Estate RE 909 If paying by credit ApplicAntsRequired RE 435 Completed and signed by applicant. Official transcripts or course completion certificates for Real Estate Principles, Real Estate Practice and/or one other required course not needed, if previously submitted. RE 237 (See below.) Completed by applicant and live scan service operator. license fee Refer to RE 206 for current fees. Cashiers check, check, or money order made payable to: Department of Real Estate RE 909 If paying by credit card. Titles of forms referenced by number. All of these forms are available on DRE s Web site at RE 206 Exam & Licensing Fees RE 226 Employment Verification RE 227 Equivalent Experience Verification RE 228 Employment Certification RE 229 Avoid Potential Denial of Your license Application RE 237 Live Scan Service Request (Applicant) RE 237B Fingerprint Information RE 423 Examination Qualification Requirements RE 435 Salesperson Exam/License Application RE 435A Salesperson Exam/License Instructions RE 436 Broker Exam/License Application RE 436A Broker Exam/License Instructions RE 909 Credit Card PaymentGenerAl informAtion Make two photocopies of the copy provided.

3 After fingerprints are completed the live scan service operator will retain the original. You should return the second copy to DRE and keep the third copy for your records. State of CaliforniaDepartment of real eState Exam/License Application chEckListRE 216B (Rev. 7/18)General InformatIon Apply for the real estate Salesperson examination and the real estate Salesperson license at the same time. Do not submit photocopies of this form or fax this enclosed instructions (RE 435A) before completing and submitting this Application to ensure that you understand the requirements and that the proper qualifying documentation and Exam/License fee are submitted. Note: Fees submitted with this Application are not refundable or transferable. If you fail to qualify for or pass the examination within two years of the date this Application is filed, the fees will not be applied to any future DatEExpiration DatEDatE Exam passEDapplIcatIon Is for: (Must check one box)C real estate Salesperson examination and license complete items real estate Salesperson license only (if already scheduled for examination) complete items 1-13 and $ $245 Total due to DREwith this $305 applIcant InformatIon1.

4 Social sEcurity numbEr or inDiviDual taxpayEr iD numbEr (required RefeR to PRivacy Notice oN Re 435a) 2. birth DatE (mm/dd/yyyy)3. have you ever applied for a california real estate exam?.. if yEs, list examination iD#. (if known).. yEs no_____4. applicant s namE (must bE your lEgal namE) - Last fiRst middLe suffix5a. mailing aDDrEss strEEt aDDrEss or post officE box5b. city5c. statE5D. Zip coDE6. Do you reside in california?.. if no, an rE 234 is required (refer to rE 435a). yEs no7. currEnt phonE numbEr (required) ( )8. currEnt Email aDDrEss (required - print CLearLy) 9. businEss cEll phonE numbEr ( )10. businEss tElEphonE numbEr ( ) 11. arE you currEntly sErving in thE military? yEs no12a.

5 HavE you prEviously sErvED in thE military? 12b. if yEs, wErE you honorably DischargED? yEs no yEs no (see re 435a for expedited processing instructions)13. Do you now hold or have you ever held a california real estate license ?.. If yes, complete 13a, B, c, and d below. yEs no13a. typE of licEnsE13b. iDEntification numbEr13c. Expiration DatE13D. namE on licEnsEexamInatIon InformatIon14. When you are qualified for the examination would you prefer to use YES Please notify me by email when I am qualified for the examination. eLicensing to schedule your own examination date? no proceed to item use only rEstrictED violationsform lEttEr / notEsExam procEssorDatE procEssEDsEnDEr/DatE sEntlicEnsE procEssorDatE procEssEDdre use OnLy dre use OnLylic. iDExam iDState of CaliforniaDepartment of real eStateSaleSperSon Exam/License applicationRE 435 (Rev.)

6 7/18)DrE rEcEivED DatEdre use OnLysacramEnto frEsno los angElEs vicinity oaklanD san DiEgo othEr: EarliEst DatE you can takE Exam (mm) (dd) (yyyy) 15. Exam arEa prEfErEncE 16. timE prEfErEncEI am requesting a reasonable accommodation; RE 413 & supporting documents are 435 Page 2 of 3 BackGround InformatIoncarefully read and provide detailed answers to questions 28-33. you must provide a "yes" or "no" response to all questions, and completely and accurately provide the detailed information required. attach additional sheets if you need more space. Each additional sheet must be signed by the applicant and employing broker, if any. failure to disclose pertinent information may result in denial of your license Application and/or havE you EvEr bEEn convictED (see paraGrapH aBoVe) of any violation of thE law at thE misDEmEanor or fElony lEvEl?

7 If yes, complete Item 34 WItH InformatIon on eacH yEs no29. arE thErE criminal chargEs pEnDing against you at this timE, or arE you currEntly awaiting JuDgmEnt anD sEntEncing following Entry of a plEa or Jury vErDict? If yes, complete Item yEs no30. havE you EvEr haD a DEniED, suspEnDED, rEstrictED or rEvokED businEss or profEssional license (incluDing rEal EstatE), in california or any othEr statE? If yes, complete Item yEs no31. arE thErE any license Disciplinary actions pEnDing against a businEss or profEssional license you holD at this timE? If yes, complete Item yEs no32. havE you EvEr bEEn rEQuirED to rEgistEr as a sEx offEnDEr pursuant to thE provisions of sEction 290 of thE california pEnal coDE or any comparablE law of any statE or govErnmEntal unit? If yes, complete Item yEs no33. havE you EvEr bEEn orDErED to cEasE, DEsist anD/or rEfrain from Doing an act(s), or from violating a law, rulE or rEgulation by, or citED for a brEach of Ethics or unprofEssional conDuct, by an aDministrativE agEncy or profEssional association in california or any othEr statE?

8 If yes, complete Items yEs no namE of applicantlIcense InformatIon18. havE you usED any othEr namEs ( , maiDEn namE, formEr marriED namEs, aka s, Etc.)? 19. gEnDEr yEs if yEs, list all namEs usED: _____ no malE fEmalE20. initial working status (must check one) yes. plEasE issuE my license in a working status with thE Employing brokEr or corporation inDicatED on itEms 21-27. whEn markED "yEs", itEms 21-27 must bE complEtED in full anD signED by sponsoring brokEr/officEr. no. i Do not havE an Employing brokEr/corporation at this timE. plEasE issuE my license in a non-working status. Do not complEtE itEms 21-27. lEavE itEms 21-27 brokEr or corporation iD #dRe use oNLy22. brokEr/corp. Expiration DatE23. businEss tElEphonE numbEr ( )24. sponsoring brokEr or corporation (Print name as it appears on license do not list dBa s)25.

9 Main officE aDDrEss of sponsoring brokEr or corporationBroker CertificationI hereby certify under penalty of perjury that I am a licensed real estate broker, and that I have read the applicant s answers to all questions in the Application , and that upon the applicant being issued the license there will be a written agreement on file in my office covering the material aspects of employment relationship including supervision, duties, and compensation of the applicant named on this form under the employment provisions of Section 2726 of the Regulations of the Real Estate am aware of the provisions of Section 3700 of the Labor Code which requires every employer to be insured against liability for workers original signaturE (Sponsoring Broker / Licensed Officer) printED namE of licEnsED officEr (if corporation on line 24.)"convicted" as used in question 28 below includes: All state, commonwealth, possession, or federal misdemeanor and felony convictions, and all military and foreign convictions.

10 A verdict of guilty by judge or jury, a plea of guilty, a plea of nolo contendere (or "no contest"), or a forfeiture of bail in the courts. convictions expunged under penal code sections , and or equivalent non-california statute must still be disclosed. proof that a conviction has been expunged under penal code sections , and must be submitted with the Application . convictions must be disclosed no matter how long ago they occurred and whether the convicted person was a minor (under 18 years of age, if tried as an adult).exceptions to "convicted": do not dIsclose Any Juvenile Court adjudication. Any conviction sealed under Penal Code section or Welfare and Institutions Code section 781. Any conviction under Health and Safety Code section 11357(b), (c), (d), or (e), or Health and Safety Code section 11360(b) after at least two years have passed since the date of the 435 Page 3 of 334. detaIled explanatIon of Item 28 and/or onE linE for Each violation anD proviDE Explanation bElow.